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Comparison of Laminectomy Alone and Laminectomy with Fusion in Patients with Lumbar Canal Stenosis
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A.A Ghasemi *   |
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Abstract: (9230 Views) |
| BACKGROUND AND OBJECTIVE: Lumbar canal stenosis due to degenerative process can cause low back pain, neurogenic claudication, significant neurologic deficit and disability. Although efficacy of laminectomy and laminectomy with fusion has been established in management of patients with lumbar canal stenosis, but which method is more efficacious in patients with 2 or more levels lumbar canal stenosis has not been clearly defined. The aim of this study was to compare surgical results of laminectomy and laminectomy with fusion in patients with 2 levels or more lumbar canal stenosis.
METHODS: This cross sectional study evaluated 70 patients who underwent surgery for lumbar canal stenosis at two or more levels during 2009-2011. Based on surgical modality patients were divided into two groups: laminectomy group and laminectomy with fusion. Surgery was performed by two surgeons. Clinical outcome of patients was assessed by visual analogue scale. Lumbar lordotic angle was compared before and after surgery. Surgical complications such as intraoperative bleeding, wound infection, CSF leak, pneumonia, urinary tract infection were compared between two groups as well. Follow up period was 14 months (8-27 months).
FINDINGS: Seventy patients (41 males and 29 females) with the mean age of 54±12.3 years underwent surgery. Thirty nine patients were allocated to laminectomy group and 31 patients allocated to laminectomy with fusion. Visual Analogue scale (VAS) was 6±1.5 in laminectomy group and in laminectomy with fusion group was 7±1.2 that respectively reached to 2±0.8 and 2.2±0.9 after surgery (laminectomy→ p=0.043, fusion→ p=0.036). Lumbar lordotic angle in laminectomy with fusion group was 32±14 and reached to 38±10 that was improved meaningfully (p=0.014). Surgical complications such as intraoperative bleeding 130±40 ml (p=0.03), wound infection in 2 cases (p=0.011), CSF leak in 1 case (p=0.031), pneumonia in 1 case (p=0.026), urinary tract infection in 1 case (p=0.033) were meaningfully lower in laminectomy alone group.
CONCLUSION: The results of this study revealed that laminectomy alone and laminectomy with fusion were equally effective on clinical outcome of patients with lumbar canal stenosis at 2 or more levels, but laminectomy with fusion was more effective in correction of lumbar lordotic angle. |
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| Keywords: Lumbar canal stenosis, Laminectomy, Laminectomy with fusion, Surgery |
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Full-Text [PDF 209 kb]
(2902 Downloads)
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Type of Study: Research |
Subject:
Biochemical
Received: 2014/04/22 | Accepted: 2014/04/22 | Published: 2014/04/22
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